Responding to the publication of the NHS Long Term Workforce Plan in full, following the initial announcement on Thursday, Dr Latifa Patel, BMA representative body chair and workforce lead, said:
“We have now heard more about the plan from the Prime Minister and while we do welcome the proposals for a much-needed expansion of our workforce, it has taken far too long to see this strategy published, especially at a time of unprecedented pressure on our NHS, wider health service and social care.
“We’re dealing with more than 100,000 healthcare vacancies across the NHS and public health, and doctors and their colleagues are burning out. The Government must implement the plan to expand the numbers of doctors in our NHS and must admit to the vast shortages we have in our health service, with a sense of urgency. At the same time we have significant reservations about how it proposes to do this. The iterative approach with commitment to a review every two years is welcomed, but this must be enshrined as legislation to ensure a continued commitment. Too many lofty plans from previous governments have ended up just being aspirations, and we cannot allow this to happen again.
“Training new doctors will be to no avail if they don’t stay in the workforce, so the focus on retention is important - but doctors need to be valued fairly for their work and expertise or they will leave for better-paid jobs elsewhere. This plan is set up to fail if doctors’ pay continues to be eroded, the pay review process continues to be interfered with and pay disparities across the public health system persist.
“While it is certainly a relief to see modelled projections for the health service after years without them, it’s a shame that these figures and the assumptions behind them have not been independently verified in their entirety, as the Chancellor promised last Autumn. Without this, it will be difficult to have confidence that the plan even if implemented in full can achieve its goals.
“With many hospitals and GP practices still using outdated and archaic IT systems, the plan’s reliance on maximising technological innovation to improve labour productivity is ambitious. While a focus on fixing basic issues such as administrative burden is welcome, we need more details on how the NHS will be supported to achieve a technological expansion of the degree the plan sets out and call on government to heed the findings of the Health and Social Care Committee’s recently published report into digital transformation.
“While the plan acknowledges the need for expansion in foundation and specialty training placements and infrastructure commensurate with the growth in undergraduate medical training, we don’t yet have a credible path to get there. Approaches such as medical apprenticeships and accelerated degrees are also untested, so we have concerns about their role in addressing the crisis.
“We should not be under any illusion that a small number of physician associates will make up for the huge shortages of doctors we currently have. There must also be clarity and communication to patients around what these physician associates’ roles and responsibilities are.
“While this is an NHS plan, it is particularly important that we develop public health expertise and invest in public health, so that we’re not just looking at treating sick people but stopping them becoming unwell in the first place and ensuring service commissioning is driven only by health needs. An increase in public health training numbers is a positive step and this must be the start of a continued commitment.
“Similarly a doubling of GP training numbers is much-needed – as is increased time in general practice for the newest junior doctors. However, it is unclear how they will be supervised given how stretched our colleagues working in practices are, and where they will work in our increasingly dilapidated and outdated premises. Retaining our current workforce of GPs and practice staff must be prioritised in the short term.
“For this plan to be effective in improving care for patients, whilst also addressing working issues for NHS staff, there must be a firm commitment from Government to fully funding and delivering it. Without this, the hopes contained in the plan simply will not be realised. The future of the NHS is firmly in the hands of this Government.”
Notes to editors
Amended for clarity 10am 1/7/23.
The BMA is a professional association and trade union representing and negotiating on behalf of all doctors and medical students in the UK. A leading voice advocating for outstanding health care and a healthy population. An association providing members with excellent individual services and support throughout their lives.